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Home My WebLink AboutPermit Electrical 2006-12-21 , ~ .\ -. , .' .".r () '\J~' , CITY OF u,.-RINGFIELq, OREGO~, .,'\~-' " ! . '. .f l-D~I ~ I ulCl I v . ',1, "'L-i ~' '2ipi \."", , SPRINGFIELD ~ .~ f'I\ - 1 225 '.rll', In STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICA}r fERMIT APPLICATION City Job Number U t1 - () ll/J 3 l?' Date 1. LOCATION OF INSTALLATION \qs;( r S\ LEGAL DESCRIPTION \'103 3G:1 I d.- 007 tJU JOB DESCRIPTION ~ CarvYlLc:.:Q- 3, COMPLETE FEE SCHEDULE BELOW A. New Residential- Single orMulti-Family per dwelling unit. Service Included 1000 sq. ft. orIess Each additional 500 sq. ft. or portion thereof $106.00 $ 19.00 Permits are non-transferable and expire if work is not started within ISO days of issuance or if work is Suspended for ISO days. Each Manufact'd Home or Modular Dwelling SeIVice or Feeder $50.00 2. CONTRACTOR IN~TALLATION ONLY B. Sen'ices or Feeders -Installation, Alterations or Relocation: Electrical Cvu~"ctor Alert Electric Inc 200 Amps or less 201 Amps to 400 Amps Address 1970 N. 28th Street 401 Amps to 600 Amps 60 1 Amps to 1000 Amps City SprinCTf ield Phone (-541) 747 - 2 213 Over 1000 AmpsIVolts Reconnect Only $ 63.00 $ 75.00 $125,00 $163.00 $375.00 $ 50.00, ~() J Supe1Visor License Number 2 4 3 S C. Temporary Scn'ices or Feeders Expiration Date 10/01/2007 Expiration Date OS/22/2007 InstaDation, Alteration or Reloation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. . D. Branch Circuits . Constr. ContI', Number 12 7 7 2 Signature of SupeIVising Electrician ~t!t:~~ . Owners Name . r1 ~)n (' n h X1T'6\ Address" '\ OtSf<t -:t - ~{- - City-5p lJ d-- Phone ) OWNER I ~STALLATION .... New Alteration or Extension Per Panel One Circuit $43.00 Each Additional Circuit or with Service or Feeder Permit $ 3.00 , E. Miscellaneous (Sen'ice/feeder not included) -El!ch Installation' ,0.. The installation is being made on property I own which is not in~ fqr sale, lease or rent. Pwnp or inigation $ 50.00 Sign/Outline Lighting $ 50,00 Limited lL...tt/lResidential $ 25.00 Limited Energy/Commercial , $ 45.00 Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges W \!J~TOTALOF ABOVE---/./-- . ~ cL;(), -' . 8% State Surcharge ,,//~ G" 0 ) d .S 0 100Admi>Uslmtiver J>hl- / <7,0 Vv TOTAL '''"-' ~ 0. cr Shared Drivc(T:)lBuilding FomulElectrical Pennit Application l~.doc Owners Signature: Inspection Request: 726-3769 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01638 ISSUED: 12/21/2006 APPLIED: 12/21/2006 EXPIRES: 06/21/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1958 I ST ASSESSOR'S PARCEL NO.: 1703361200700 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Reconnect Owner: JACOBSON ANN D Address: 1958 I ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor ALERT ELECTRIC INC License 12772 Expiration Date OS/2212007 Phone 541-747-2213 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk Type: NO 11 C E Downspouts/Drains: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR Ad( 180 DAY PEHIUU. tion Stor~f~,e",~~\A;~~~~~: ~~Ul i lciitv r84UII~::i you (0 Spec\~llm$rluJ,telbnadopted by the Oregon Utility N Notification Center. Those rules are set forti o'~bAR 952-001-0010 through OAR 952-001 33J:. y~::. :n:.)' s:~a;:l':'~i3;':'':' .:.~ tl.':' ;;,.1.:..., L \ calling the center. (Note: the tele hwf;ation Descri numberforthe Oregon Utility Notiflc Center is 1-800-332-!2344). $ Per Sq Ft Square Footage Description Type of Construction It' I' B'd A t or mu Ip ler or I moun Value Date Calculated Paee 1 of 2 Status Iss u ed CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01638 ISSUED: 12/21/2006 APPLIED: 12/21/2006 EXPIRES: 06/21/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Service Reconnect Amount Paid Date Paid $5.00 $2.50 $4.00 $50.00 12/21/06 12/21/06 12/21/06 12/21/06 Receipt Number 3200600000000000635 3200600000000000635 3200600000000000635 3200600000000000635 Total Amount Paid $61.50 I Plan Reviews ~ To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reouired Insnections I Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 54i -726-3759 Phone Job/Journal Number COM2006-01638 COM2006-01638 COM2006-01638 COM2006-0 163 8 Payments: Type of Payment CreditCard cReceint 1 RECEIPT #: Description Service Reconnect + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By STEVEN J. HADELBERGI ALERT ELECTRIC {':...., of Springfield Official Receipt .. elopment Services Department Public Works Department 3200600000000000635 Date: 12/21/2006 Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 021753 Phone Payment Total: Page 1 of 1 2:52:48PM Amount Due 50.00 2.50 4.00 5,00 $61.50 Amount Paid $61.50 $61.50 1212 I/2006